The influence of personality disorders on desire for hastened death among terminally ill cancer patients

Abstract

An ongoing debate exists regarding the legal, moral, and practical issues pertaining to physician-assisted suicide (PAS) in this country. Researchers have identified a construct called “desire for hastened death” which they believe accounts for interest in PAS and euthanasia as well as suicidality (Rosenfeld et al., 2000). Previous research on desire for hastened death has indicated that psychological and social factors play a significant role in terminally ill patients' desire for death. ^ This study tested the hypothesis that the presence of personality disorders would be associated with higher levels of desire for hastened death in a sample of terminally ill cancer patients living in a palliative care facility. In addition, it was hypothesized that personality psychopathology would moderate the relationships between the clinical variables of depression, hopelessness, spiritual well-being, social support, and symptom distress, and desire for hastened death. Personality psychopathology was assessed using the MCMI-III (Millon, 1994); desire for hastened death was assessed using the Schedule for Attitudes toward Hastened Death (Rosenfeld et al., 1999; 2000). ^ The presence of personality disorders in general was not associated with desire for hastened death. Further, personality disorders did not appear to moderate the relationships between clinical variables and desire for hastened death. Several methodological limitations, most notably low power, may have contributed to lack of findings. Implications of supplemental analyses suggested that when grouped into clusters, the presence of certain disorders were predictive of increased desire for hastened death. Cluster A Personality Disorder significantly added to a multivariate model predicting desire for hastened death. Directions for future research in this area are presented. ^